Transplantation of Autologous Adipose-Derived Stem Cells for Chronic Nonhealing Wounds

Abstract

<p>細胞治療是國際上廣受醫學界矚目的一種新興療法，可促進慢性困難傷口癒合。幹細胞因其獨特的生物特性，具有豐富的醫療應用潛力，其中脂肪幹細胞(ASCs)為間質幹細胞之來源之一，可透過微創手術（如：抽脂手術）從脂肪組織中取得，因其可用於促進組織再生及傷口癒合而受到關注。脂肪幹細胞再生能力的潛在機制涉及細胞分化和多種旁分泌作用，可增加膠原沉積、血管新生及減少發炎。2018年9月，衛生福利部頒布《特定醫療技術檢查檢驗醫療儀器施行或使用管理辦法》，有條件地允許6項自體細胞治療技術在臺 灣進行臨床應用，包含脂肪幹細胞應用在慢性困難傷口癒合。執行此項新興醫療技術前必須接受審查，以判定其在臨床場所及人體細胞組織優良操作規範實驗室中的安全性及執行效率，且須在脂肪組織的採集與運輸、脂肪幹細胞的分離與培養，以及細胞的運輸與移植實施標準化方案。藉由臺灣現行法規對製造自體脂肪幹細胞的嚴格品質管制，可讓脂肪幹細胞療法成為慢性困難癒合傷口病人的治療選擇之一。</p> <p> </p><p>Cell therapy is an emerging practice in the international medical community used to facilitate the healing of chronic wounds. Stem cells have exhibited potential for therapeutic applications because of their unique biological properties. Adipose-derived stem cells (ASCs) can be obtained from fat tissue through minimally invasive procedures such as liposuction. Thus, ASCs have gained attention as a source of mesenchymal stem cells, which can facilitate regeneration and wound healing. The mechanism underlying the regenerative properties of ASCs involves cell differentiation and several paracrine effects, which increases collagen deposition, causes angiogenesis, and prevents inflammatory states. In September 2018, the Ministry of Health and Welfare issued the Regulations Governing the Application or Use of Specific Medical Techniques or Examinations, which conditionally allow for the clinical application of six autologous cell therapy technologies in Taiwan. The clinical use of ASCs for chronic nonhealing wounds is included. This novel medical technology must be investigated to determine its safety and efficiency in both clinical facilities and good tissue practice labs. Standardized protocols, including those for fat tissue harvest and transportation, ASC isolation and expansion, and cell transportation and transplantation, should be implemented throughout the process. With stringent quality control for autologous ASC generation in compliance with regulations in Taiwan, ASC-based therapy can be a promising treatment option for chronic nonhealing wounds.</p> <p> </p>